Resection of the liver from living donors for transplantation is a special surgical challenge. The success of the surgical procedure depends heavily on preoperative planning for which knowledge of the hepatic vasculature, as well as of the presence of hepatic neoplasms and their relationship to adjacent vessels, is crucial.
Conventional catheter angiography has long been considered the "gold standard" technique for evaluation of hepatic arterial anatomy. However, the morbidity and mortality associated with catheter angiography, coupled with the limitations of this procedure in demonstrating the hepatic venous anatomy, have provided impetus for the development of non-invasive methods . Nowadays, CE MRA is increasingly considered a superior imaging modality for evaluating the hepatic vessels. Comprehensive information concerning the hepatic parenchyma as well as the complex arterial, venous and portal venous systems can today be obtained using a "one-stop-shop" examination.
Special care has to be taken when planning liver resection for living donor transplantation. As the rate of vascular abnormalities is comparatively high in the liver, accurate depiction of the arterial, venous and portal venous systems is important for successful resection of the graft as well as for replantation into the host. Knowledge of the relationship between intrahepatic neoplasms and adjacent vessels is also crucial for planning resection with tumor-free margins.
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